APPENDIX 2 ANNUAL QUALITY STATEMENT CONSULTATION (VERSION ... · APPENDIX 2 ANNUAL QUALITY STATEMENT ‐ CONSULTATION (VERSION 3) COMMENTS AND DECISIONS TAKEN 1 OVERALL COMMENTS ACTION

APPENDIX 2 ANNUAL QUALITY STATEMENT ‐ CONSULTATION (VERSION 3)

COMMENTS AND DECISIONS TAKEN

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OVERALL COMMENTS ACTION TAKEN

I really like the look and the overall read Thank you It looks really good and is easy to read Thank you Format much easier to read than previous versions Thank you The overall impression is of and well presented, bright document

that is well laid out. Ensure we only produce in colour though. For the electronic version, hyperlinks on the contents page would be useful, Really liked the Did you know boxes. Really liked the We said – Target – How we did tables.

Thank you

Overall reads well and the ‘you said, we did’ theme is consistent throughout which I really liked.

Thank you

Really like the AQS – looks very smart. Thank you There doesn’t appear to be any reference to the health visiting,

school nursing or paediatric community nursing services in the list of services provided by the (t)HB (page 4) though Flying Start does get a specific mention. There are achievements we could possibly include such as the fact that most Health Visitors are now trained in infant massage and regular classes are offered throughout Powys. This has been shown to have benefits for maternal and infant mental health and I wonder about including this in the section on page 10 on early intervention if appropriate.

Agree we need to add in reference to health visiting. Thank you

I think the layout of the AQS is great, there's a real mix of colour and photos and snap shots of information to make it easy to read and enjoyable. The tables provide further detail highlighting that we are focused on what we want to achieve within the organisation reiterating we strive to be a high performing organisation. Maybe before you go through the HCS a picture of

Will consider using the HCS picture We will include Reablement in the 15/16 version



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how they look at the overarching governance and accountability may be helpful to set the scene as to what the subsections are all about. There's a nice little circular picture out there with the standards etc... You could maybe mention reablement services, it’s not working at its best at the moment as they are having to deal with a lot of DTOC's and care packages however it is an example of integration with tHB and PCC delivering primary care. If you feel there is a place for this in the AQS then I'm happy to provide you more information depending on what your thoughts are

Over all I like the style – it looks fresh It was fairly easy to read, although quiet long, so if you read it in one swoop like I did you can forget some bits Wasn’t sure if some of the things were the same kind of subjects as last year e.g. leg clubs seems to be mentioned every year or frequently again virtual wards ‐ will people think we are just repeating ourselves. Possible things to add: Was VJ winning nurse of the year award and what this mean and why? Also mentioning the number of long service awards or something similar to recognise the contribution of staff

Thank you We have worked towards getting a balance between the various areas mentioned but we struggled to get information from everyone across Powys. The AQS is an appendix of the Annual Report, this will be referenced in the annual report.

I like the format of the report and it is easy to read. I think it is generally really good. But it is unfortunate that we missed so many targets as this does give quite a negative impression. Could you maybe consider a traffic light system instead of the tick and cross to denote something like “some improvement but still working towards the target”.

Thank you We will consider the format. However, regardless of how we present the information, we still have not met the targets set.



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Key areas We feel the document is poor in regards to formatting,

font and colours Information on performance and services seems to be

quite readable for the general public in a language that everyone should understand.

Non consistent footer’s Non consistent tables Arty effects have ruined the content on some pages.

Thank you for your comments. We will look at these. However, we are guided by NHS branding guidance.

A short note of congratulation on the annual quality report.

It has continued the standard set by last years report in terms of attractive layout (hard facts interwoven with pictures and diagrams) and being an easy but informative ‘read’. I particularly liked the way in which our ‘looking forward’ commitments of last year were reported as ‘We say…/target/And how we did’ at appropriate points in the report. In addition, the manner in which specific facts were highlighted in a ‘Did you know’ box were a nice feature.

We mentioned in the Chairman’s report that Powys LHB have now recovered the operational responsibilities for the Mental Health Services. Perhaps in our ‘Looking Forward ‘ section we could include a ‘What we will do’ objective to underline the priority that we will be giving the Service, now that it is our responsibility.

Finally I am not sure whether reporting against the new National Output framework should feature in this report….or is this something for next year?

Thank you This will be within the Annual Report



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OVERALL COMMENTS ACTION TAKEN The Tier 1 targets are reflected in some areas of the AQS and they will also be referenced in the Annual Report. This can be further developed in 15/16.

As someone who is not employed by the HB it may not be appropriate for me to comment, however, we are all working for same population so I found the document helpful and informative and the following occurred to me: (page 4 and page 5)

Thank you

Looks good to me – well done You may want to consider mentioning the IMTP as a service

direction for the next 3 years and the importance the quality statement has in relation to ensuring quality is uppermost in delivery.

Need to cross reference to the Annual Report to see how the IMTP / quality is referenced within.



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COMMENTS ACTION TAKEN

1 2 3 Page 3 ‘sharing’ and ‘shared’ both used close in 1 sentence (para

3) Thank you

Page 3, RE’s input ‐ use of ‘more’ twice in 1 sentence (para 3) Thank you 1. “in that we share our boundary with one local authority.”

We do not share a boundary with Powys LA we have the same border and cover the same area.

2. To find out more read the Quality and Safety Committee Annual Report

This needs a link to enable people to find it.

This is correct, in that we are coterminous with PCC. This will not change. There is no quality and safety committee annual report

Para 3: Possibly change order of words as I had to read a couple of time before it made sense e.g. Unlike other Health boards, we are unique as we share our boundary with .... Para 4: Think this need to be clearer ‐ that we are currently repatriating Mental health services ‐ instead of saying directly managing ‐ suggests we already do, which is then contradicted by the later Para 6: Sentence needs a , or of rejig ‐ too long eg We pledge over the coming year, to work with you to transform our service and bring better healthcare closer to home. Para 8: Reorder suggestion:

Agree. To be changed. Agree. To be changed. Agree. To be changed.



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In 2015/2016 our focus will remain on ensuring the Health Board strives to deliver its vision of 'truly integrated care, centered on the individual' and will do this through continuous monitoring of the quality and safety agenda needed .... Para 9: Needs a . to long

This will remain the same. Agree. To be changed.

4 Page 4 – primary care does not seem to be listed – general practice, general dentistry, pharmacy, optometry needs to be included.

Thank you. Agree this will be amended.

1. This page is not easy to read, makes little sense and has no intrinsic value in its current layout.

2. Are the colour’s coordinated 3. Green is not ideal for people with either colour blindness,

dyslexia. 4. They have not been broken down into the correct areas

as we also do general surgery, general medicine and maternity services.

Please rethink this page

Comments notes, we will look at this. We will add these in.

P4. Should health promotion/ promoting health/ public health feature somewhere? The HB definitely has a large role within this arena.

We will not change what is in the AQS. The information has been provided by PHW.

5 Pg.5 Fine Thank you P5. Wonder whether something should be mentioned in 2nd para

under ‘who we care for’ about the vulnerable, thinking about the large numbers of LAC children who live in Powys, etc.

We will not be using this in the 14/15 AQS.

More on public health working to help us with knowing our population demand so we can better plan in the future to meet need.

Already considered this as part of PHW in document.



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As this is the first mention of General Practitioner should it be in full followed by (GPs)

Agree

6 Page 6 – opening paragraph misses out how we spend money in Powys which makes the flow of the narrative a bit odd

Thank you. We will amend.

Under an agreement we contract for services in hospitals (List below) for residents in Powys. But Powys patients have in reality access to any hospital in the UK and Western Europe and this list makes it looks like they could be limited to treatment in these trusts/premises. (its not wrong but not right either) “Image needs resizing to be less stretched”

Thank you for your comments. No changes will be made.

What new roles e.g. Information added to this effect. 7 Pg.7 Fine Thank you 8 Page 8 – Why is the phrase ‐ at risk ‐ in quotes? This relates to different categories of patients. In this instance it

relates to patients who have chronic conditions. 1. Table needs tidying the orange highlight looks messy

(text needs tidying) 2. Healthcare assistant could be more visible

We will look at this.

I have attached some suggested changes in the way the table on p.8 is reported. The Excel file sets out amendments to the way flu and HPV progress is presented. I have basically changed the emphasis of the pass/fail assessment to year on year change rather than achievement of the absolute target. This is consistent with aspiration of improving performance which is what we stated we would do in the 13/14 Annual Quality Statement. Pass/fail assessment against the absolute target does not properly show where progress has been made which deserves to be recognised in the

Thank you, changes made.



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AQS. If the table could be altered to include my updated reporting and assessment for flu and HPV it would be appreciated.

Confirmation from SB, 21/07/15: 90% target applies to all age groups. N.B. It is an indicative target, rather than an absolute, pass/fail measure of success. If there is some way to reference it’s indicative status that might help to contextualise the figures.

Thank you

the use of "in the first" place twice in such a small paragraph maybe second sentence needs to be softer ‐ e.g. helps prevent

Agree

9 Pages 9 and 29 have no images on them and look more bland than the others.

Thank you. These will not be changed as they are balanced against other colours and images.

Page 9 – partnerships for health “health board” not capitalised There is no need to capitalise health board Page 9 ‐ Mental health training – The section starting “Similarly”

feels like its missing a couple of words to help it read better Italics will be added to strengthen the section

From SC 21/07/15: Promoting Self Management Support Across Powys The team at the Pain and Fatigue Management Centre, Bronllys, have been delivering a suite of self management interventions across Powys Invest in Your Health – the Invest in Your Health Programme is run in local venues throughout Powys. It is a 6 week programme (2½ hours per week) led by a member of staff from the Health Board working with a trained volunteer facilitator. The programme looks at helping individuals develop a series of evidence based self management skills to help maximize health and wellbeing

Thank you. This will be added to the ‘Individual Care’ section, as this is rather light and requires strengthening. Added



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Community Pain and Fatigue Management Sessions. These are a pair of sessions which provide an overview of pain and fatigue management strategies. The sessions are run throughout Powys and we recommend that people attending these sessions also attend the Invest in Your Health Programme. Each session is 2½ hours and they are usually 7 weeks apart. Residential Pain and Fatigue Management Programme. The residential programme is an intensive three week programme during which individuals stay at the Pain and Fatigue Management Centre, Bronllys Hospital from Monday to Friday and go home at weekends. During this time they will take part in a variety of activities which will help to improve their quality of life despite having chronic pain or fatigue ACTivate Your life – A new programme starting to roll out across Powys. ACTivate your Life is a 4 session talk of 2 hours each week designed to support emotional concerns, as well as useful strategies which apply to everyone to promote positive health and wellbeing. Consultant Psychologist and Head of Pain and Fatigue Management Centre, Owen Hughes says, Our servce is all about helping people to help themselves. Participants who really embrace the tools and techniques we have on offer see a huge improvement in their quality of life”.

Maybe need to head ‐ what we have achieved/ done something to give an indicator of what is coming next Para 1: switch wording Four Schools in Powys.....

The section will not be changed to reflect this suggestion. Agree.



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Para 1: Doesn't actually say what is awards is ‐ what is a healthy school? e.g. healthy school meals, sickness day of pupils ...... Para 2: take out in Para 3, bullet point 3: and the outcome of this questionnaire was......

More detail on award sought. To be added to document. Agree. Information sought.

10 A line space needed on page 10 both before and after the Working with Older People heading.

Thank you. Agree

Page 10 – suggests 24% of 4/5 year olds are overweight but it’s gone down to 23% by page 11

Thank you. Noted

Text needs neatening and image bottom right centralising. We will look at this. Working with older people:

There are nurse led falls prevention services in all sites in Powys. With open referrals, the clinics are available to any one at risk or with a fear of falling. The clinics offer multi‐factorial assessment with diagnostic assessments, advice, signposting and referral to appropriate services for intervention. This holistic service looks at the big picture and supports people to remain safe and independent in their own home. Nurses work alongside the physio and occupational therapy teams to provide falls prevention programmes.

Agree.

11 Staying healthy in Powys, the 10 point pie chart, it’s in green which I automatically think means good, the smoking one tells me what we are aiming for which puts it in perspective, I do not get that perspective from the other points. Could some of these be referenced on the looking forward page?

Green has been used to display a positive message, staying healthy. It is not a traffic light indicator. The colours have been taken from the HCS. No, not all of them.

Page 11 – where there are differences is it really the percentage change (as quoted) or should it be percentage point difference?

Thank you. We will clarify and reword.



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Only comments are that it may have been a more positive message re Flu Vaccines to incorporate the 50.4% uptake in Health care staff exceeding the Target and being one of two Health Boards in Wales to do this. Page 11 point 2

This is about public health not the staff.

1. Poor Layout, Shadow/gradient effect unnecessary, numbering looks un neat especially 3 and 8.

2. Fundamentally not easy to read why the fancy effects. (Simple Table).

Thank you. We have noted the comments; no changes will be made.

AAA screening This has not been accepted. The AQS can only present a limited amount of information.

12 Safe Care, need the page no’s in the table. Move Trusted to Care to Page 24. Page numbers are inserted. 1. Shadow overlapping text under safe care

2. Table looks messy due to being too small so we can see santa claus in a chair.

We will tidy this up. The table is the same size as the other tables.

13 Preventing Patient Falls 5th bullet point All our patients are at high risk of falling as per the NICE guidance on in‐patient falls. We introduced new documentation to support the (Multi‐factorial) assessment of patients and the planning of interventions to reduce the risk of falling.

We will amend the text to state ‘actions which we have taken include’….

Preventing Patient Falls The number of patient falls in our hospitals reduced from 449 in 2013/14 to 432 in 2014/15. These numbers include patients who fell on more than one occasion. This may be better put in context like against the number of patient bed days in 2013/14 59,860 or some other measure so the number is in context and does not look so large?

We will add in the number of bed days.



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Bed Days: 13/14 = 449 falls / 59,294 bed days = 0.75% 14/15 = 432 falls / 60,574 bed days = 0.71% Admissions: 13/14 = 449 falls / 4,738 admissions = 9.4% 14/15 = 432 falls / 5,045 admission = 8.5%

Should there be something on page 13 around medication errors / incidents?

No not on this occasion

1. No one in the office likes the picture “Walking Dead Effect”

2. Text bottom right covered by picture 3. Table Counts need to be central 4. Source on information needs to be included

This will not change Text will be tidied up Source to be identified

The table is not related to the above wording - possibly needs to be an explanation - that we also report on or improvements that have been made against previous figures - have we done anything

Agree. To change.

14 Page 1 re concerns the table looks to read that of the 131 received 57 remain open or 50% are still open! Is this correct or will displaying the data in this way lead others to this assumption

Thank you. It is correct.

Page 14, the complaint figures for 2013/14 & 2014/15 don’t tally with the total received. Should these add up in the table - first column does - second doesn't - Tin has explained both side Should we be explaining why so may are left open or what we are doing to improve??

Thank you. It is correct.



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1. Table contents need to be centred and title redone

instead of deal should be dealt as its historic data. 2. Data source needs to be included with table 3. Highlighted note section is overlapping text 4. Did you know (why darker blue background?) 5. No footer

This is the same as everywhere else No footer on the left hand page – this is normal practice.

15 1. In 2014/15, we had three complaints referred to the PSOW. In all three cases the PSOW agreed with how we had handled the complaint.

What did they agree that it was handled ok? Bad????? 2. Text suffering again due to wasteful picture and

overlapping footer. 3. Another page that lacks consistency on edging image/pic 4. Hand hygiene (do we really want to list a figure from a

time period where we know the data was spurious)

Hand Hygiene: is this a true reflection given that possibly the audits were not undertaken consistently? Is there another measure we could use

Thank you, that is correct, our complaints handling were upheld. Hand hygiene will be taken out.

16 Page 16, extra word in the sentence “That we would roll out of the “Virtual Ward” scheme to other areas of the organisation”.

Thank you. Agree

1. Is picture relevant to topic the page is about effective care??????? Possibly better in breast feeding section. (patient at home with doctor?)

We will look at whether this needs to be changed



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Mid locality does not exist now‐ it’s in the south locality ( for the Virtual ward roll out)

We can include this in the 15/16 version. This relates to the 14/15 financial year.

On page 16 we refer to 27 serious incidents and I think a few more details would be appropriate – consequences and improvements for example. Cathie has suggested rewording to “incidents reportable to Welsh Government” as the numbers are small, providing any breakdown of consequences may result in Data Protection issues. . Themes emerging include falls and pressure damage. Key lessons learnt include the importance of early identification of those at greater risk of falls and/or pressure damage, ensuring vital equipment such as alarm mats and pressure relieving cushions are made available as soon as it is identified they are required and the importance of encouraging patients to follow advice and guidance in the management of falls and pressure ulcers.

Words added in relating to falls. Difficult to say too much as these are individual incidents and will be patient identifiable. Agree. To be added.

17 P17: I like the visual representation of increased ear procedures and other procedures but suggest splitting these graphics into two separate boxes as the current layout could be confusing.

Thank you. We will look at this.

Pg.17 fine Thank you We are now working closely with a volunteer organisation to

offer audiology support and have drop in clinics in Llanidloes and Llandrindod with the Hear to Help team. The team offer advice on management cleaning, and care of hearing aids and they just recently won a Powys t Health Board volunteers award. They are located within hospital opd on the same day as the audiologist, offering seamless care. Throughout Powys we have developed Video conferencing to support patient care. We have had successful MDT meetings, and listening therapy sessions.

Will not be added on this occasion.

18 Is it carpal tunnel or carpel? We will check



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1. Again picture in confusing breast feeding performance pics under carpal tunnel section? Text has poor layout.

2. No footer

We will look at this. Thank you

We need some amendments to page 18, can we remove ‘ Making these changes has saved £100,000 per year’ as this is not correct, and change ‘ Previously patients frequently waited more than 16 weeks to see a Consultant and greater than eight weeks to have a test done outside of the county’. To ‘Previously patients frequently waited more than eight weeks to have a test done outside of the county’.

Thank you, we will look at this

19 Effective Care – MIU’s could we add another sentence to encourage the use of MIU’s over A&E where appropriate?

Thank you

Page 19 – perhaps we also need to include that some of our GP practices provide a minor injuries enhanced service – please contact …. if you need further detail on where this is provided and a summary of the spec. Response from SH 21/07/15 ‐ Practices that provide are: Rhayader Haygarth Crickhowell Knighton Presteigne Montgomery Cemmaes Road Llanfyllin Llanfair Caereinion

Agree.



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In addition to this Llanidloes, Newtown and Machynlleth have taken on the minor injury service previously provided by the Heath Board at the relevant community hospitals

1. Picture size interfering with footer. 2. Alignment of purple text boxes is messy

Thank you for your comments. This will not change.

20 1. Table of content yet again ruled by picture Thank you for your comments. This will not change.

Dignified care: Is it cheeky to consider if we should put something about the older peoples commissioner award and nurse of the year award. I t was recognising the work in day hospital, maintaining people in their own homes, preventing admission to hospital by early intervention, enabling people to understand and manage their own chronic disease, and supporting palliative patients . Also it recognised the development of falls prevention services Powys wide. Do give me a ring if you want any other information on it. Could this be a measure of what has been achieved? Also a midwife achieved a national award? Could this be something to put in? And today’s nhs award winners! wow What about contacting Jason Carroll re pharmacy and the work they have done in community?

To go into the Annual Report.

21 Pg. 21 Fine Thank you 22

1. No footer 2. Again text bubble interfering with sensible layout where

is the quote coming from?

Noted Source identified.



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Source: User Experience Survey, Fundamentals of Care Audit 2014

Para 1: Note that the All Wales audit does cover peads, neo nates and not sure adults although we dont do the audits as we do not have the services. Final Para: What is bugwatch?? to the ‐ take out ‐ possible use across the

No change. Agree to change.

23 Dignified Care – Internal inspections, were these inspections annual, quarterly? Also was Welshpool not inspected? Would Glan Irfon be included? Could you strengthen what will be done to address the actions highlighted?

Thank you, this area has been mislabelled.

Also on page 23 I don’t feel the comments from the inspections will particularly inspire confidence in our community hospital. When I had a walkabout on Llewellyn, the only recommendations were to put a sign by the call bell in the toilet, and add some feedback forms to our ‘Knowing How we are Doing Board” which we did. There were no recommendations around cleanliness or care, and the high standards were commended. This was also the case with our most recent HIW Inspection, and some comments made were: “excellent, conscientious and caring” “We observed that all patients were well cared for and their personal hygiene needs were being met” “Patients informed us that they felt staff had time to listen to them and were able to discuss aspects of their care when required” “Patients benefitted from attention to their hydration and nutritional needs”

These relate to walkrounds not inspections, to be relabelled.



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“Patients informed us that they had not experienced any difficulties in locating staff during the day or night, and received prompt responses to requests for assistance when they used their buzzer” “Overall the ward environment was clean and pleasant” “Patients had the opportunity to take part in varied activities at regular intervals during the week which promote both physical and mental well being”

I’m sure that other community hospitals have got some good positive quotes following inspections that would reassure the local community about the standard of care in Powys and inspire confidence in those people who either use our services themselves or have family who do

Just some thoughts – otherwise it looks great.

1. Image Shadowing interferes with text 2. Layout is appalling for easy reading you don’t read it

because it’s so messy. 3. Are the comments in regards to where these sites failed

or what they were measured on?

Thank you. Noted.

24 Page 24, column 2 the word Butterfly has been split (Butter Fly) Thank you 1. No footer

2. Place Sarah Rochia’s name first and title afterwards! 3. Again text layout, size and consistency is not helpful.

Thank you No, this will not change Noted

1st Column, bullet point one: Sentence structure

Thank you – will look at this.



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T2C Box: Was the Butterfly scheme already in place?? Clocks I think were also already in? Did we put Butterfly scheme in last years? We could put in about working with the university to develop training in Dementia Care

Checked. Do not change.

25 Page 25 – text box could probably say the same in fewer words Thank you, this will not be changed. Typo: add s to patient - Writing down the reason when

patient do not take their tablets Thank you.

1. Blurry image 2. Colour choice of text box is poor with background. (why

not hide the cars with it?) 3. No footer

A different picture will be inserted.

26 1. No footer 2. Text box positioning 3. Better layout of facts (please realise ambulance

performance is poor and has been for ages) 4. Include that we are working with WAST and the

geography of Powys is not indicative of a rapid response

Noted, Thank you We note the comments re ambulance performance True regarding geography

Timely care‐ should we talk/do a picture our primary care /GP access ‐ as larger pop want to access that than a focus on the ambulances? (Section 5 you could swap the ‘did you knows’ over and add a picture of a GP practice instead of the ambulance)

Last year 14/15 ambulance times were relevant.



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27 P27: re MRI waiting time patient story in bubble; “8 months” stated – should this be 8 weeks? (I hope so!!) 8 weeks is referenced in the narrative section alongside the bubble.

No this is correct

The mobile MRI included patients from the mid and South localities.

Thank you

Timely Care ‐ Waiting times for referrals – Can we add a sentence to say what we are doing to address the 317 that were outside 26 weeks? From DV 22/7/15 ‐ I suspect this information was provided by the Information Team, I know there are more up to date numbers available on long waiters but I am not sure if they could cross match them back to the 317 – I have copied Paul Cronin who should be able to advise. From PC 22/7/15 ‐ The information we have is not patient identifiable so we cannot say what happened to those specific 317. What we would have is an updated position. If you would like the latest information it is available on IFOR, PTHB’s information portal. If you would like to be set up to view the RTT info then please let James know and he will sort for you, and point you to the RTT information page(s).

We will ask commissioning for a view on this. Following feedback – no change made.

Timely Care ‐ Waiting times for cancer treatment, I did not find it easy to understand what we were trying to say in either the English or Welsh paragraphs.

We will look at this.

With some of the targets it would be good to know whether they are all Wales or Powys set ones, it would be good to show where

We will look at this



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we are better than the all Wales target and a commitment to maintaining it.

Page 27 – the text that describes the Cancer waiting times is convoluted to the point of being incomprehensible

We will look at this

Response from SH ‐ No practices offer appointments until 6.30pm on 2 days per week.

Agree. To change AQS.

1. Footer missing Comment noted

28 Page 28 – was it a deliberate choice the use the phrase “developing new ways of listening to people” together with a photo of a hearing aid?

Thank you

1. Table at expense of image again 2. No footer

Noted

29 Pages 9 and 29 have no images on them and look more bland than the others.

Noted

Page 29 – is it obvious what Tros Gynnal Plant is? http://www.trosgynnal.org.uk Tros Gynnal Plant is a leading Welsh children’s charity working with some of our country’s most vulnerable and marginalised children and young people. They may be experiencing difficulties in accessing appropriate services in health, education and social care ‐ these include children with disabilities, children with emotional health needs and children seeking asylum. Tros Gynnal Plant has projects across Wales offering independent and confidential support to children and young people and families through advocacy, participation, counselling, family

We will interpret this for you.



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group meetings and conflict resolution. We also offer advocacy support for those experiencing problems with emotional health and wellbeing.

1. Font consistency type and size The Patient Story will be removed.

Just to say that the Eye Care Liaison Nurse is already in post based in Glan Irfon. She commenced in April. Under individual care section.

Not relevant to 14/15 AQS. This relates to 20/4/15.

30 Page 30 – isn’t it a bit odd to focus this section just on the one thing that we actually failed on?

It is the only target, but we will add in the flu comment provided by OH.

1. Page footer missing Noted

31 Page 31 Pay bill – inconsistent measures 1/5 for us but 80% for others – not every member of the public will be able to make the comparison – choose either 1/5 and 4/5 or 20% and 80%

Noted and agree

Page 31 – ugly phase ‐ we have developed a strategy that will be developed further

We will change this

Page 31 – just have a personal dislike of things in quotation marks without a link to the specific source of the quotation. There is inconsistent use between ‘ and “ throughout document

We will look at the Chat2Change booklet and amend

Page 31 looks to have a typo‐ are the years the wrong way round “all clinical staff to have undertaken IQT Bronze by 2016 and at least 80% of staff by 2017” Response from BM 21/07/15: The 80% by 2017 target for IQT Bronze is for all staff. Ideally clinical staff should have achieved silver by then.

To check with W&OD. It relates to clinical / non‐clinical staff. Agree, to amend AQS.

IQT table: Is this just a repeat on the previous page? Noted.



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1. Messy but actually one of the better pages Thank you

32 1. No footer but a great picture for the virtual ward area! Thank you

Looking forward ‐ say something to introduce the increased pace of the integration agenda with PCC?

Not accepted. Possible feature in the annual report.

33 Page 33 says all by 2016 for IQT As above Mid locality does not exist now‐ it’s in the south locality

( for the Virtual ward roll out) Not relevant to 14/15 AQS. This relates to 20/4/15.

34 35 36 1. Different fonts, please look to make layout neater all text

on the left find out more on the right Thank you

OTHER There is no mention of veronica Jarman who was awarded the RCN Older Peoples Commissioners Nurse of the Year in 2014 and the overall winner of Nurse of the Year Wales award This is a fantastic example of our staff and service and should be in there somewhere.

In the Annual Report

Enjoyed reading this, it’s refreshing to see the things we have done well alongside those we haven’t done so well.

Thank you

Font/spacing is similar but not the same throughout the document – suggest either using same font and spacing throughout or clearly distinguishing between fonts. I recall some guidance from RNIB many years ago that stated justified margins should not be used as people with visual impairment struggle with the different word spacing it creates.

Justified margins are not used. One font is used but size changes to fill space.

Suggest labels on photos featuring PtHB colleagues (eg team/role and location) and eradicating use of stock photos if at

We asked all areas for contributions but we had very few provided.



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all possible. How about putting out a Powys announcement inviting contributions of photos? Many colleagues have them for use in presentations/studies etc. So far as I can tell no photos feature activity north of Llanidloes, perhaps consider including photos from other sites/services as sometimes PtHB is perceived as “south‐centric”.

I attach an email outlining a readability tool, to be used with your word version of the document, as this may help in this area. Basically you can set up word to tell you the readability of your document i.e. how easy is it to read? What reading age is it? What education level you would need to read it fluently? The attached is a simple step by step guide to setting it up. Really easy, 2 minutes then it will do it at the press of a button anytime you want.

Thank you

I have attached a draft of the south locality annual report in case there is anything in there you wish to use.

Thank you, we have used some of the content

Documents

APPENDIX 2 ANNUAL QUALITY STATEMENT CONSULTATION (VERSION ... · APPENDIX 2 ANNUAL QUALITY STATEMENT ‐ CONSULTATION (VERSION 3) COMMENTS AND DECISIONS TAKEN 1 OVERALL COMMENTS ACTION